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SOUTHERN IDAHO MEDICINE PLLC
NPI 1861105694
Clinic/Center in Jerome, ID

Active since December 26, 2022
207 E MAIN ST, JEROME, ID 83338(208) 308-7738 Get Directions Write a Review

NPPES record last updated: December 26, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southern Idaho Medicine Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN IDAHO MEDICINE PLLC (NPI 1861105694) is a healthcare organization registered as a clinic/center in Jerome, Idaho and active in the NPI registry since December 2022. The organization lists Jessicca Marie Crismor, Owner, as its authorized official.

NPPES Registry Identity

NPI1861105694
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSOUTHERN IDAHO MEDICINE PLLC
Location Address207 E MAIN STJerome, ID 83338-2334
Mailing Address137 Woodridge DrTwin Falls, ID 83301-8156 · (208) 308-7738
Phone(208) 308-7738
Organization SubpartNo
Authorized OfficialJessicca Marie CrismorOwner · (208) 308-7738
Enumeration DateDecember 26, 2022
NPPES CertifiedDecember 25, 2022
✔ NPI 1861105694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
207 E MAIN ST, Jerome, ID 83338
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Idaho Medicine PLLC's NPI number?

The NPI number for Southern Idaho Medicine PLLC is 1861105694. It was assigned to this organization in the NPPES registry on December 26, 2022.

Where is Southern Idaho Medicine PLLC located?

Southern Idaho Medicine PLLC is located at 207 E Main St, Jerome, ID 83338. The listed phone number is (208) 308-7738.

What is Southern Idaho Medicine PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Southern Idaho Medicine PLLC was last updated on December 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.